“The house lo mein’s my favorite,” Susan continued. “It has four meats, including shrimp.”
“All right. House lo mein and . . .” Remington studied the menu again. “How about chicken broccoli?”
“Delicious.” Susan liked the combination. “They make an excellent wonton soup, chock-full of Chinese vegetables and even some shrimp.”
“Let me guess.” Remington pressed his fingers to his temples in the manner of a psychic. “You like . . . shrimp.”
“Very much,” Susan admitted. “You’re not allergic, are you?”
“Yes,” Remington said. “Deathly. When I said we’d order the house lo mein, I was just hoping to test your ability to handle anaphylactic shock.”
“Uh-oh,” Susan said with mock seriousness.
“What?”
“When I okayed the chicken broccoli, I was testing
Remington laughed. “I’m a surgeon, remember? I’d skip the epinephrine or the wimpy antihistamines and steroids and go straight for the tracheostomy.”
As their dinnerware consisted only of chopsticks, Susan hefted one. “What would you do? Poke me till I got a splinter? Tough to do a trach without at least a butter knife.”
Remington reached into his pocket and dropped a handful of odds and ends to the tabletop, including a packaged scalpel blade, a tiny plastic suction tube, two nickels, and a cell-sized defibrillator. “I always travel prepared.”
Susan shook her head, then rolled her eyes.
“When you work with attending surgeons, you have to be. If you don’t have what they want the moment they want it, you have to weather disdain or, worse, a tantrum.” Remington watched Susan closely. He seemed to be studying her features, and a slight smile crossed his face. He clearly liked what he saw. “But you must know that. You seem to have an incredible handle on how to get the most superior surgeons to do your bidding.”
Before Remington could say another word, the server approached. “What can I get for you?”
Remington swept his gear back into his pockets. “We’d like two bowls of wonton soup to start. Dinner for two, with house lo mein and chicken broccoli.” He looked at Susan to confirm she still wanted what they had discussed.
Susan nodded.
The server tapped the order into a cousin of the palm-pross. Their menu screens changed abruptly. “Anything to drink?”
Remington went silent and let Susan answer for herself. “Tap water, please.”
“I’ll have water, too, please. And a pot of green tea to share.”
“All right.” The server typed their drink order into his palm-pad, and their menu screens added another box.
Susan did not bother to look at her screen. From long experience, she knew it now contained a list of ingredients and calorie counts for the foods they had ordered. She had no allergies, and she wasn’t worried about superfluous calories. Remington also did not bother to look. Susan suspected he never thought about such things, nor did he seem to need to.
Picking up where he’d left off, Remington said, “I meant that, about getting surgeons to do your bidding. No one in the history of the universe has gotten the self-proclaimed ‘greatest neurosurgeon’ to apologize or admit a mistake. Starling was our last case of the day. We had to keep the OR open overtime.”
Susan had no idea. When she had left the unit, Neurosurgery had not yet made a decision about Starling. Now, Remington had her absolute attention. “What did you find?”
“You tell me.”
Susan knew. “An incompletely repaired A-V fistula.”
Remington laughed. “You were right, and that only ratcheted up your celebrity among the neurosurgery crowd.”
“I have . . . celebrity?”
The server arrived with the soup, placing a bowl and squared-off hard plastic spoon in front of each of them.
“Thank you,” Susan said.
The wonton soup was exactly as Susan remembered it: clear, lightly salted broth with meat dumplings and vegetables, shreds of pork and two large shrimp. Remington picked up his spoon. “A couple of days to recover, and Starling’s on her way home.” He filled his spoon and sipped the hot soup carefully.
“Home?” Susan could scarcely believe it. “After nearly two years on the inpatient unit?” She took a taste of her own soup, reveling in the savory mix of flavors. “Just like that?”
Remington took some more soup. “Just like that. We’re not a long-term unit, Susan. Open ’em up, fix ’em, send ’em home.”
“Yeah.” Susan could not help thinking Starling had lost nearly two years of her young life for nothing. Had someone only noticed the subtle signs of heart failure earlier, Starling could have spent the last year in school. She did not blame Dr. Sudhish Mandar. She suspected he had done nothing wrong, and Remington had simplified the problem. Likely, the A-V fistula had widened farther than it originally appeared, and the venous pooling problem occurred a short distance from the initial spot. “You know, twenty-two different residents and probably ten or eleven attending physicians missed the problem.” It seemed the very definition of malpractice; yet no one appeared worried about that eventuality.
Remington kept eating, swallowing before he spoke. “It happens, Susan. More often than we want to believe. We think we know what’s going on; we put the patient in the appropriate place; then we find out it’s something entirely different. Psychiatrists aren’t wired to look for circulatory defects, just as surgeons don’t worry whether a patient loves or hates his mother before putting him under the knife.”
Susan wondered if Remington had just subtly insulted her profession, then decided to let it go. “But twenty- two months of unnecessary hospitalization? Remy, to a child, that’s a lifetime.”
Remington put down his spoon to lean across the table toward Susan. “If you don’t think to look for something, you generally don’t find it. Everyone believed the psychiatric issues were primary until you heard that gallop rhythm. Whether it was there all those months or only appeared when you did, we’ll never know. According to the chart, no one else heard it until you pointed it out. It’s very subtle. Susan, if I hadn’t known to listen for it, I probably wouldn’t have heard it, either.”
“The cardiologists heard it.”
“It’s their job to hear it. And they also had your notes to go by.” Remington sat back but still did not touch his food again. “Medicine has come a long way in the last hundred years, but it’s still an imperfect science that relies on human judgment.” He smiled. “I think the first sci-fi medical scanners came along in the 1950s. Here we are, eighty-five years later, and we still can’t take a handheld device, run it around someone, and have it diagnose everything that ails him.”
Susan sipped her soup thoughtfully while Remington talked, then said, “We do have devices that can read some things through the skin.”
“Sure we do. Pulse oximeters are some fifty years old, and skin blood glucose monitors came along only a few decades later. Now, we can read a lot of things through skin using lights, magnets, vibrations, and lasers, but it’s still only data, the levels of various chemicals and gases running through the blood. For diagnoses, we rely on human intuition, experience, knowledge, and intelligence. And, in my opinion, we always will. It takes thought to figure out things as amazingly complex as the human body, all the things that can possibly go wrong with it. No machine could ever do that.”
Until a few days ago, Susan would have agreed wholeheartedly.
When she did not, Remington pressed. “Don’t you agree?”
“Well,” Susan finally said, “I don’t think we’ll ever have medical tricorders, lifeless devices that can make diagnoses about body parts they can’t see or touch.” Susan absentmindedly took more soup, chewed, and swallowed.
Remington prodded. “But . . .”
Susan did not disappoint him. “But . . . thinking robots could retain more information than any human. They
